14 Fla. L. Weekly Supp. 580b
Insurance — Personal injury protection — Motion to dismiss and motion for summary judgment in action brought by medical provider against insured’s employer’s commercial carrier for benefits and for presuit information are denied as premature where, although commercial carrier was wrong insurer and insured’s PIP carrier covered provider’s claim, commercial carrier did not inform provider that it was the wrong insurer presuit
EMERGENCY PHYSICIANS OF CENTRAL FLORIDA, as assignee of Martin Collins, Plaintiff, v. AUTO-OWNERS INSURANCE COMPANY, Defendant. County Court, 9th Judicial Circuit in and for Orange County. Case No. 05-SC-11640-0, Division 73. April 12, 2007. Deb Sammons Blechman, Judge. Counsel: Cameron E. Shackelford, Meier, Bonner, Muszynski, O’Dell & Harvey, P.A., Orlando. Rutledge Bradford, Rutledge Bradford Attorneys at Law, Orlando.
ORDER DENYING DEFENDANT’S MOTION TO DISMISS AND DENYING DEFENDANT’S MOTION FOR SUMMARY JUDGMENT
THIS CAUSE has been argued upon Motion to Dismiss and Motion for Summary Judgment. Mr. Collins was injured while driving his employer’s work vehicle. He presented the name of the insurance company for his employer’s commercial carrier when he went to the emergency room. That carrier is the Defendant in this case. Subsequent to emergency room treatment, Mr. Collins and Defendant carrier agreed that Mr. Collins would seek primary coverage through his personal injury insurance carrier, State Farm. Meanwhile, the emergency room physicians, having been presented the insurance card for the commercial carrier, submitted their bill and subsequent demand letters to Defendant. Thinking that a response was not required to the medical provider because State Farm would cover the claim, Defendant’s claims adjuster did not reply to the requests for payment by the emergency room treatment provider. The medical provider filed suit for benefits and for pre-suit information. Subsequently State Farm paid the 80% PIP benefits and 20% Med Pay benefits. Now the commercial carrier has moved to dismiss Plaintiff’s claim and also for summary judgment on the basis that Plaintiff sued the wrong insurer. Plaintiff argues that the suit would not have had to have been filed if the adjuster had simply replied to the medical provider, or that there still may have been needed some pre-suit discovery in relation to the Med Pay claim. Much argument has been made in regard to the merits of both parties’ positions. The following findings are entered.
Recently a 9th Circuit Court appellate panel decided the case of American Vehicle Insurance Company v. Florida Emergency Physicians Kang & Associates, P.A., as assignees of Stephenie Carrico, CVA05-17 (Jan. 2007) [14 Fla. L. Weekly Supp. 352a]. That decision upheld a county court decision which held that pre-suit information is to be provided to a medical provider as assignee of an insured, notwithstanding the insurance company’s position that the medical bill had been applied to the insured’s deductible. The Carrico decision is instructive in regard to the nature of information discoverable by a provider from a PIP carrier, and also the scope of the carrier’s obligation to furnish information. Citing Florida Statute, Section 627.4137, the court said that under Section 627.4137, a carrier must provide information to any claimant, not merely to the named insured. The Court also stated that this statutory provision reflects a legislative recognition of the importance of a claimant’s access to insurance information in making settlement decisions, and that if pre-suit information was not required to be provided, that carriers would ignore discovery requests thereby spawning litigation.
This Court is mindful that the instant case presents an additional factual element, in that there was no question in the Carrico casethat the insurance company was the primary insurer for the insured party. However, given the trend for courts to read the statute as requiring insurance companies to give sufficient information to a claimant to put them on notice of claim defenses so that they can evaluate if suit should be filed or not, it would seem premature to grant either of Defendant’s motions. See also Gelbard, M.D. a/a/o Larry Wheaton v. Progressive Consumers Insurance Company, 12 Fla. L. Weekly Supp. 262a (County Court, 17th Judicial Cir., 2004) which stated that an insurer cannot thwart the intent of the statute by not sending a denial as an incorrect insurer and then use failure to notice the proper insurer as a defense.
WHEREFORE, Defendant’s Motion to Dismiss and Motion For Summary Judgment are hereby DENIED.
